Youth 3-5Youth 6-7Youth 8-10

Read Carefully and Sign Below

I hereby acknowledge that participating in the Loudoun County Fair Power Wheels Derby can be a potentially hazardous activity and that all participants should be in good medical and physical condition. I assume all risks associated with my/my child’s participation in the Power Wheels Derby including, but not limited to, bodily injury, contact with other participants and animals, emotional distress, effects of the weather, and damage to personal property. I waive and release the Loudoun County Fair, Loudoun Fair & Associates, Inc., all directors, staff, partners, sponsors, vendors, officials, volunteers, and their representatives and successors from all claims and liabilities of any kind arising out of my/my child’s participation in the Power Wheels Derby.

In signing below, I hereby acknowledge and agree to all the above terms. I certify that the above-named participant is in good medical and physical condition and has permission to participate in the Power Wheels Derby. Further, I grant permission for the use of any photos or videos of me/my child for marketing purposes.

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